There are more than 100,000 people on a transplant waiting list in the US alone. Each year, only about a quarter of these patients will receive life saving transplants because of the significant shortage of organ donors. Thousands of patients on the transplant list die every year without a chance to receive an organ. The gap between the number of patients awaiting transplant and the number of organs available continues to widen.

Obtaining family consent for organ donation is a crucial rate-limiting step towards successful donation. The lack of understanding of the organ donation and organ procurement process by the families’ of the potential organ donors is one of the barriers.

A study conducted in Texas and published in the Journal of Trauma indicates that only 57% of families consent for organ donation. There were several specific barriers towards giving consent for donation identified by this study:

#1 Ethnicity
Hispanic families were four times less likely to give consent for donation. African-American families were seven times more likely to decline donation. During the past 20 years, African Americans and Hispanics represent only 12% and 11% of organ donors. Lack of understanding of brain death and the organ donation process were considered the likely explanation by the authors of this study. Specific approaches focusing on minority groups might improve the donation rates among minorities.

#2 Age and cause of death of the patient.
Older age (aged 50 years or older) and a medical cause of death of the potential organ donor were independent predictors for the failure to consent for organ donation by the family. The authors of this study indicated that the families of older patients would likely consider organ donation to be out of the realm of possibility. Many families were also unaware of the patient’s previous wishes and attitudes towards organ donation. It was found in the previous studies that the knowledge of a patient’s preference to donate increased the likelihood of donating by seven times. Efforts to improve donor designation, including the DMV organ donor program, might improve organ donation rates.

#3 Circumstances surrounding the request for consent
It was found that the sooner the family is approached about organ donation the higher the chances of obtaining the consent. Also, being approached by a member of the OPO (organ procurement organization) team, rather than by an independent member of the healthcare team also increased the rate of donation. Some large medical centers only allow specially trained individuals to approach the family about organ donation.

In conclusion, the rates of organ donation remain suboptimal. Identifying and eliminating barriers for successful organ donation will save thousands of lives every year.